Hip Flashcards
What is the ROM of the hip
flexion extension abduction adduction internal rotation external rotation
primary hip flexors
Iliopsoas
hip extensors
gluteus maximus
biceps femoris
semitendinosus
semimembranosus
hip abductors
gluteus minimus and medius
hip adductors
pectineus
adductor brevis
adductor longus
adductor magnus
What can cause a dislocation of the femoral head
high-impact/high energy injury
What are symptoms of a dislocation of femoral head
severe pain
decreased or no ROM
other injuries
What is associated with anterior dislocation of the femoral head
flexed
abducted with external rotation
+/- femoral nerve injury
larger femoral head on X-ray
What is associated with posterior dislocation of the femoral head
flexed adducted with internal rotation leg length loss \+/- distal pulses sciatic/femoral nerve dysfunction smaller femoral head on x-ray
What are radiographs for femoral dislocation
AP pelvis
AP/lat femur to knee
CT
femoral dislocation txt
emergent reduction after X-ray repeat X-ray/Ct cruches wt bearing as tolerated exercises close followup
Should a replacement hip that is dislocated be reducted
no send to surgery
What can femoral dislocation cause
osteonecrosis
arthritis
nerve dysfunction
chronic pain
What does a hip fracture involve
proximal femur
- femoral neck
- intertrochanteric
hip fracture risk factors
age white female sedentary tobacco alcohol dementia medications
pathophysiology of femoral neck fractures
twisting injury
impacted or displaced
pathophysiology of intertrachanteric fracture
fall directly on hip
line between greater and lesser trochanter
What are hip fracture signs
recent fall non-weight bearing groin pain (buttock) externally rotated, abducted, shortened limb pain with ROM no straight leg raise
hip fracture radiography
AP pelvis
lateral hip
+/- MRI/CT
hip fracture txt
surgery
DVT prophylaxis
DEXA
What can hip fracture cause
mortality ambulation loss non-union osteonecrosis arthritis
What are the types of hip replacement
total hip arthroplasty
hemiarthroplasty
Pelvic fracture types
stable
unstable
acetabular
pelvic fracture symptoms
groin pain
non-weight bearing
hip/buttock pain
What should be evaluated for pelvic fractures
open fracture CMS GU injury c-spine ATLS
pelvic fractures radiographs
AP pelvis Judet/oblique pelvic inlet/outlet CT scan AP chest c-spine
What do about acetabular fractures
non-operative
bedrest
limited activity
pelvic fractures txt
analgesics protected weight bearing DVT prophylaxis DEXA Unstable -heme resuscitation - compression - surgery
pelvic fractures cause
leg length change mal/non union CMS injury GU injury DVT chronic pain DJD
